Recognition and Management of Necrotizing Neutrophilic Dermatoses

Purpose of Review: Necrotizing neutrophilic dermatoses are frequently misdiagnosed as necrotizing fasciitis, resulting in inappropriate surgical intervention and amputation leading to unnecessary morbidity. This paper reviews recent literature to highlight clinical features, pearls for diagnosis, and potential treatment options. Recent Findings: Necrotizing neutrophilic dermatosis should be suspected in patients with classic cutaneous findings, presence of systemic symptoms, absence of an infectious source, and neutrophilic infiltrates on histopathology, particularly if necrotizing fasciitis is suspected but the patient worsens with surgical debridement and antibiotic therapy. While reported as separate entities in the literature, necrotizing Sweet syndrome and necrotizing pyoderma gangrenosum with systemic inflammation are likely the same disease. Summary: Improved awareness, accurate diagnosis, and early dermatologic consultation may improve morbidity and mortality for patients with necrotizing neutrophilic dermatoses.

Duke Scholars

Author Daniela Kroshinsky Dermatology